Need help on cpap settings

[Beaumont1124]

        I have used resmed auto sense 10 for 2 years with no help on sleep quality. Wake up every 1-2 hours every night. Would you mind looking at my sleep report and see if there is any hope? I have enclosed one night for you to look at. Use resumes nasal pillow(n30I), settings on Cpap is 5 min. and 9 max on manual settings. Was set on these settings with 45 minute ramp time. Thanks

[Gideon]

Welcome to the forum, we will help you, we will get you better than you currently feel.  Getting you all the way may take another machine (ResMed VAuto, a BiLevel) but let's hold off on that thought until we see what we can do with your AutoSet.

First, the AutoSet is a good machine but it is not setup properly for your apnea.
The biggest issue that you have is your flow limits.  I suspect UARS, Upper Airway Resistance Syndrome, but without a sleep study I cannot prove it, at least not yet.

I would like you to change your settings

Set Mode = Auto (This is easier to optimize your settings, we may or may not suggest a fixed pressure again, don't know yet)
Set min Pressure = 7 (This will allow us to get maximum use and therapeutic value fro the EPR)
Set Max Pressure = 12 (Not too high as I suspect flow limits will drive pressure to the max )
Set EPR = 3, FullTime (EPR is our major tool to treat the Flow Limits which I suspect are worse that your numbers indicate)

This should lower the Flow Limits that you are currently seeing and (hopefully) eliminate the RERAs that you are currently experiencing.  RERAs are by definition a series of flow limitations ending with arousal.
I do expect to change these settings based on the results from using them.

[Beaumont1124]

Thanks, I did do sleep study in 2017-18. I have a copy in you need it later. Made the changes to the autosense already, thanks.

[Ockrocket]

Your machine is currently set to a fixed pressure of 9.0

You need to switch to auto instead of fixed, and then start off with the settings suggested by Bonjour.

[Beaumont1124]

        Probably slept little better new settings. Still woke up every hour or two, but no problem with change in settings. Rera look better.

[staceyburke]

I will leave the setting for the experts you have answering, however, your leak rate needs to be addressed.    Right click on the leak rate and go to dotted line and check mark the "leak rate upper threshold".  That will help you identify the amount the machine can accommodate before the leak is to big to adapt to. 

Check out the Collar link at the bottom in the signature.

[mesenteria]

Probably slept little better new settings. Still woke up every hour or two, but no problem with change in settings. Rera look better.

Please pay attention to my next observation:

Your machine is STILL showing that it is on CPAP mode, not on AUTO, which is what bonjour asked you to do.  You may need to use the manual to do this, but if you know how to do so, please get out of straight CPAP mode and switch the machine to AUTO.  Then, tomorrow, if the other settings suggested by bonjour are correct, you'll hopefully see a substantial diminution of your AHI.

[Sleeprider]

Probably slept little better new settings. Still woke up every hour or two, but no problem with change in settings. Rera look better.

Please pay attention to my next observation:

Your machine is STILL showing that it is on CPAP mode, not on AUTO, which is what bonjour asked you to do.  You may need to use the manual to do this, but if you know how to do so, please get out of straight CPAP mode and switch the machine to AUTO.  Then, tomorrow, if the other settings suggested by bonjour are correct, you'll hopefully see a substantial diminution of your AHI.

Actually, his machine is in Autoset mode, although there is a ramp starting at 5.0.  We can see the pressure adjusting and mostly staying near the maximum pressure setting of 12.0 due to high flow limitations.  The EPR is at 3.0 so and while there are some leaks, the results are improving with AHI at 2.84.  I'm not in this thread (until now), but I'm guessing Beaumont would greatly benefit from bilevel pressure, but will be moving to a minimum of 10.0 and maximum of 14.0 with EPR 3.

The Resmed SD data only reports the settings from before noon. If changes are made later in the day, the old settings show up, so we have to read the charts.

[Gideon]

I'll go with that
Min = 10
Max = 14
EPR = 3 (current value)
and Turn Ramp off. If you need the ramp we will add it back in.

[mesenteria]

I must not be looking at the right information, Sleeprider.  When I look at either of his two last panels, the index at the left margin says the mode set is 'CPAP' and it says the pressure is fixed at 9.0  Where else should I be looking?